Percutaneous access devices are used to introduce extracorporeal medical devices, such as catheters, through the skin for a variety of purposes, including to transport fluid, conduct diagnostic tests, access blood for dialysis, monitor pressure, and deliver drugs. Hydrocephalus, for example, can require the use of an external ventricular drainage (EVD) catheter to remove fluid from a patient's ventricle. Hydrocephalus is a neurological condition that is caused by the abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles, or cavities, of the brain. CSF is a clear, colorless fluid that surrounds the brain and spinal cord, and that constantly circulates through the ventricular system of the brain and is ultimately absorbed into the bloodstream. Hydrocephalus, which can affect people of any age, but affects mostly infants and young children, arises when the normal drainage of CSF in the brain is blocked in some way. Blockage of the flow of CSF requires an increasing pressure for CSF to be absorbed into the bloodstream. This increasing pressure can interfere with the perfusion of the nervous system. Hydrocephalus can be treated by introducing an EVD catheter through a burr hole in a patient's skull and implanting the catheter in the patient's ventricle.
One common risk associated with the use of many catheters, including ventricular catheters, is the risk of infection at the site of the catheter insertion. Current reported infection rates of EVD catheters range from 1-25%, with the typical rate of approximately 17%. Minimizing or eliminating the risk of infection is critical for devices that contact the brain or cerebrospinal fluid. Current efforts to approach this issue include coating or impregnating the catheter with antibiotics or hydrophilic solutions that do not allow the bacteria to colonize on the surface of the device.
While these devices have proven effective, there remains a need for an improved percutaneous access device to facilitate insertion of a catheter while minimizing or eliminating the potential risk of infections to the tissue surrounding the percutaneous access site.